Chapter 10: A Lesson About Leadership and an Institutional Blind Spot

Chapter 10: A Lesson About Leadership and an Institutional Blind Spot



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In this chapter, Dr. Tomasovic shares a story that taught him lessons about leadership.



Publication Date



The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center


Houston, Texas

Topics Covered

The Interview Subject's Story - The Leader; Personal Background; The Patient; Building/Transforming the Institution; Understanding the Institution; On Leadership

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.


History of Science, Technology, and Medicine | Oncology | Oral History


Stephen Tomasovic, PhD:

I thought of -- you may want to guide me further at this point. But as we were talking about this transition between LeMaistre and Mendelsohn and the point at which I was beginning to move into administration and the effect that had on it, I thought of a story that illustrated for me most closely how leadership can have unexpected consequences, or that made me begin to realize that I had to be very careful as a leader because people were starting to read me and try to understand how to react to me. And I had to be careful about what I said and what I did because people -- there would be interpretations and consequences that I didn't exactly anticipate if I wasn't careful. And I learned that from not a leadership action that I took, but just from the fact that I was recognized as an institutional leader. It wasn't an action I took, but it was a reaction to me being perceived as an institutional leader, somebody important in the institution. And the story revolves around a health episode for me. This was in my late 40s. I was ending up my term as president of the faculty senate. As I said, I was on the president's key advisory group of senior leaders in the institution. I was becoming very visible in the institution.

Stephen Tomasovic, PhD:

And I still was a professor in my department doing my research. I had these various leadership roles. And I had an episode as it turned out of vestibulitis. I was sitting at my desk and I had a vestibular disturbance possibly because of some viral infection. But I don't know if you've ever had vertigo, but I went just within a very short period of time, a few seconds, from feeling a little dizzy to being unable to stand up, having my eyes exhibiting nystagmus. You're flipping, rolling your eyes. Vomiting, extreme nausea, photophobia, lying on my office floor. Fortunately it was a small office, the door was shut, and one of my research assistants to came to ask me about something after a few minutes. And I really didn't know what was going on. Had no idea. Had never experienced that. And they knocked, and I couldn't respond really, but I kicked the door with my foot. And it happened to be locked, because I was -- I don't remember exactly why. But she went and got a key, and they came in and found me like that. And they called a code in the hospital on me, because they weren't sure what was going on. And the code team came to get me. It took them a long time to get there, which I'll come back to in the end. And like code teams often are it was staffed by either a young physician or a fellow. Somebody still in GME training here. Certainly a qualified physician but not somebody with a huge amount of experience. Good enough to do CPR and take care of emergency things. So he looked at me for a minute and looked at my eyes, so forth. And my wife had arrived by that time. Somebody had called her. And there were people standing around there. And I wasn't very -- it was hard for me to concentrate, talk. But I could hear what was going on. And he said in a loud voice well, it looks like it's a cerebral event. Scaring my wife and everybody else. So they put me on this thing. Of course I was miserable. I was throwing up. Any motion at all just sets you off. You just have no -- it's just complete vertigo. They took me down to the emergency center. And like I said, at that time I was deputy -- let's see. Well, I was certainly still president of the faculty senate. And the president's office got word of this. And somebody called from the president's office asking about Dr. Tomasovic. Dr. Freireich, who was a huge figure in the institution, showed up. Couple of other department chairs were calling about it. And the young physicians and fellows in the emergency room just freaked out. They thought they had somebody really important. And they started running every diagnostic test they could think of. So they gave me -- they were started -- they go through everything that could possibly be wrong. They started testing me for meningitis. They did a spinal tap on me. Which caused the most severe long term consequence. Because I got a little postlumbar spinal fluid leak. And when you do that, for the next couple days, until you rebuild the spinal fluid, every time you stand up you get an instant migraine headache. So they ran several thousand dollars' worth of diagnostics on me in very short order. And finally the head of -- the chairman of neuro-oncology Victor Levine came in and looked at me, and he said it's vestibulitis. Just cover him up, put him in the dark, leave him overnight. He'll be fine. So that's what they did. They left me in the emergency room overnight on a gurney or the cot or whatever it was there. My wife came to get me the next morning. And I was still quite dizzy and went out leaning on the wall and in a wheelchair. I was OK within a day. But I had episodes like that periodically over the rest of my career here. But we knew what was going on, and I carry meclizine around in my pocket. If I feel myself starting to get wobbly I can take meclizine. And it's essentially Dramamine, it's for motion sickness. And so I can largely prevent it. But there's been more than one time that I've been wheeled out in a wheelchair to the car and had my wife have to drive me home, because I was just getting -- I just got caught before I could get enough meclizine on board. So the outcomes of this were there was quite an investigation because it took the code team so long to find somebody in the research areas. So they reworked how the code teams worked to make sure. They could find patients really easily. They couldn't find the faculty and staff that were in other parts of the hospital. So they did some -- there was a fair amount of investigation by the physician in chief about the cost that was run up and also about the process in general.

Stephen Tomasovic, PhD:

But that taught me that -- I realized then probably for the first time pretty clearly that if you're perceived to be an authority or an influence, people react to that. And you have to be careful what you're projecting, what you say, what you do. And I make mistakes in that way to this day. I'll say something casually, I'll make some comment casually to one of my staff, one of my directors, one of my people, and the next thing I know it's spun out into quite a deal. Because I wasn't clear enough in my direction to say well I'm interested in this but don't worry about it. Versus this is something we need to take care of, here's the steps I want you to do. So I realized that you have to be careful about leadership and communication and what you project. Because people are going to be constantly reading you and trying to interpret you, with good intentions. But it can go awry and have consequences you don't intend if you're not careful.

Tacey A. Rosolowski, Ph.D:

It's an interesting way to discover that. In addition, too, I like the way the mapping of the institution has a certain big blind spot for the clinicians.

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Chapter 10: A Lesson About Leadership and an Institutional Blind Spot